NSW Junior Medical O cer Recruitment Strategy …...in early 2016. The Phase One report confirmed...

NSW Junior Medical Officer Recruitment Strategy Review

PHASE TWO REPORT

IECO Consulting | NSW Statewide Junior Medical Officer Recruitment Strategy Review

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Executive Summary

Each year, NSW Health recruits approximately 4000 junior doctors who provide front line clinical services under the supervision of senior doctors in health facilities within NSW.

The recruitment of junior doctors is primarily undertaken through a statewide bulk recruitment campaign that runs from July through to October each year.

The NSW Junior Medical Officer Recruitment Strategy Review was commissioned by the Ministry of Health with the aim of improving recruitment practice in addition to managing the risks around industrial issues, service delivery and IT vulnerability.

The Review was undertaken in two phases with Phase One commencing in late 2014 and completed in February 2015. Phase Two commenced in June 2015 and was completed in late 2015, with the Phase Two report (this report) being finalised in early 2016.

The Phase One report confirmed the annual JMO recruitment campaign is a resource intensive and complex program that signs off on over $700 million worth of salaries and costs an estimated $5 million annually.

The Phase One report made 31 recommendations across a broad range of themes including governance, centralised recruitment panels, training pathways, selection processes, employment screening and the eRecruit system.

The Phase One report was distributed at the commencement of Phase Two of the review and was used as a consultation document. The purpose of Phase Two was to consult with a broad range of key stakeholders to seek views of the key risks, issues and recommendations identified in the Phase One report and in considering these views, to make further recommendations on a practical way forward.

The Phase One report was very positively received and there was significant support for the majority of recommendations. The Phase Two review confirmed strong support for the continuation of a statewide rectruitment campaign and a platform specific to JMO recruitment in recognition of the particular characteristics and requirements of the JMO recruitment campaign.

Phase Two of this review also highlighted some key issues with widespread acknowledgement that the emergence of a number of challenges over recent years has impacted on an already stretched system.

These include: the increased numbers of medical graduates; the range of participating health facilities which are geographically dispersed; the complexity of postgraduate training program requirements; and, in some cases, the emergence of training networks.

These external factors have contributed to a number of inherent vulnerabilities and more fundamental structural changes to the system are now required if the program is to remain viable and cost effective.

Governance remains a significant risk. There was substantial evidence gathered during the Phase Two consultation to support the view that the current governance arrangements limit the capacity of the system at large to respond strategically to emerging challenges.

A new governance model is required. The establishment of a central unit with appropriate authority to oversight the recruitment strategy, lead change and further improvements to the system, particularly with respect to collaboration with external stakeholders, would address a number of issues identified during Phase One of the review.

This report provides a summary of the key findings of Phase Two of the review, including the outcomes of the Phase Two consultation process, in addition to a suggested way forward.


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Table 1 Summary of recommendations by support, priority and timeframe

Phase One Recommendations Support Priority Timeframe

Governance

1The NSW JMO recruitment strategy, characterised by a centrally coordinated bulk recruitment campaign should continue to be supported as providing the most efficient and cost effective approach to JMO recruitment within NSW.

High High <12 months

2The roles and responsibilities of those involved in the annual JMO recruitment campaign need further clarification and restatement, with all stakeholders agreeing and accepting their roles and responsibilities.


5Further work is undertaken with relevant Colleges to improve the timing of notification and transfer of information with respect to College recommended appointments.

High Medium 12 months

6Staffing of JMO Management Units is reviewed to ensure that they are adequately resourced to undertake designated roles and responsibilities associated with the bulk JMO recruitment campaign.


7Consideration be given to the development of career pathways and professional opportunities for JMO Managers that strategically supports the sustainability of this critical cohort of the NSW Health Workforce.

High Medium 12 – 18 months

10Communication is improved regarding approval of the FTE to be advertised. This includes LHDs notifying the central panel host unit of the FTE to be advertised.


11The Ministry of Health continue discussions with the Commonwealth Department of Health regarding the timing of STP funding.

Some Low N/A

Training pathways

28Length of training contracts should be pursued for as many training programs as possible. High High <12 months


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29Work is undertaken with LHDs and Colleges to identify the number of training positions (pathways) including the prerequisite clinical experience and entry points for both run-through and uncoupled training programs.


30Work is undertaken with LHDs and Colleges to explore the most effective mechanisms of tracking trainees as they progress through the training (employment) pipeline on a length of training contract.

Some Low 24 months

31Work is undertaken in collaboration with Colleges to strengthen performance management frameworks for effectively managing underperforming trainees within the employment context.


Selection processes

15For highly subscribed positions, consideration be given to removing the words to the effect of “eligible to register with the Medical Board of Australia” (or equivalent) and having an unambiguous statement to the effect that applicants must hold current registration with the Medical Board of Australia in addition to currency of medical practices within the Australian healthcare system.


17The wording of selection criteria used in position descriptions is reviewed to support a more efficient culling process by selection panels. This assumes a more sophisticated description of the role (following a job analysis) that incorporates not just the required clinical competence skill set, but also the non-technical attributes critical to the role.

High High 12 – 24 months

18Work with individual Colleges is undertaken to establish standardised specialty specific selection criteria (this assumes a job specification analysis) at various levels of training, including streamed PGY3-5 positions.


19For regional and rural positions, consideration is given to allowing selection criteria to reflect an applicant’s interest in, commitment to, and suitability for rural medical practice.


20Strategies are explored with the aim of reducing the total number of interviews being conducted. This will include a range of strategies such as: improving culling and short-listing techniques; increasing positions utilising preference matching; and increasing the number of centralised recruitment panels.



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21Work with postgraduate medical training providers, including Colleges, is undertaken to explore other methods of assessing applicants in the recruitment process.


23Work is undertaken with relevant Colleges to align referee requirements with NSW Health policy and allow for the sharing of referee reports. This is likely to improve the quality of the referee report, in addition to reducing the administrative load on senior clinicians during the recruitment period.


Centralised recruitment panels

3Centralised recruitment panels should be supported and expanded to other specialties. High High < 12 months

4The arrangements for centralised recruitment panels, including allocation of appropriate human and fiscal resources to ensure their effective and sustainable operation, needs to be agreed between LHDs.

High High < 12 months

Annual recruitment cycle

24Further work is undertaken with jurisdictions and Colleges to improve alignment of recruitment dates with key training milestones within and across training programs. This implies a hierarchical approach to the advertising and recruitment of positions.

High High 12 months

Employment screening

26Consideration is given to strategies that will reduce the repeated 100-point checks being undertaken on junior doctors during the same recruitment campaign.


27Consideration is given to requiring applicants to upload a signed CRC consent form at the time of submitting the application and subsequently providing the original form for validation when they present for interview.

Low Low N/A

Training in recruitment and selection

8Consideration is given to working with Colleges on the development of a medically focused recruitment and selection training package, aligned with public sector employment requirements.

Some Low 12 – 24 months

Note: Phase One recommendations relating to the eRecruit system are shown in Table 4


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Table of Contents

Executive Summary 2

List of Tables and Figures 7

SECTION ONE

Preamble 8

Background 9

Methodology 11

Preliminary comments 13

SECTION TWO

Themes 15

Governance 16

Training Pathways 24

Selection Processes 28

Centralised Recruitment and Selection 35

Annual Recruitment Cycle 37

Employment Screening 38

Training in Recruitment and Selection 40

eRecruit System 41

Final Comments 43

SECTION THREE

Appendices 44

A. Terms of reference/scope 45

B. List of meetings by location 46

C. Membership of the Statewide JMO Recruitment Strategy Project Reference Group 47

D. Glossary of terms 48

Acknowledgements 50


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List of Tables

Table 1: Summary of recommendations by support, priority, and timeframe 3

Table 2: Organisations providing written submissions in responseto the Phase One Report 12

Table 3: Phase One recommendations by theme 13

Table 4: eRecruit recommendations 42

List of Figures

Figure 1: Overview of phase one and phase two 10

Figure 2: Summary of phase two review methodology 11

Figure 3: Phase Two outcomes at a glance – explanatory note 14

SECTION ONE

Preamble


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SECTION ONE | Preamble

Background

NSW Health currently recruits around 4,000 junior doctors who provide direct clinical care of patients, under the supervision of senior doctors in the public hospital system and health facilities within NSW. The majority of junior doctors are simultaneously engaged in postgraduate medical training and working in positions that meet requirements for specialty training.

The recruitment of junior doctors is undertaken through a bulk recruitment campaign that runs from July through to October each year.

In late 2014, the Ministry of Health commissioned IECO Consulting to undertake a review of the statewide JMO recruitment strategy and its components to:

• Fulfill the Health Professionals Workforce Plan (2012–2022) to improve recruitment practice; and

• Manage the risks around industrial issues, service delivery and IT vulnerability.

The review was divided into two phases. Phase One was a diagnostic phase, which commenced in late 2014 and was completed in February 2015.

The purpose of Phase One was to:

• Assess the strategy, processes and policies underpinning the statewide JMO recruitment campaign in NSW and to determine the extent to which these have contributed to improving recruitment practices;

• Determine actual and potential risks with the current JMO recruitment arrangements; and

• Establish recommendations for change, utilising a cost–benefit framework that will best ensure the strategy’s future sustainability and continued effective operation.

The Phase One report confirmed the annual JMO recruitment campaign is a particularly resource intensive and complex program with a number of inherent vulnerabilities. The report identified that whilst key stakeholders support the existing annual campaign and agree that a number of improvements have already been made in recent years, more fundamental structural changes must occur if the program is to remain viable and cost effective.

The Phase One report made 31 recommendations across a broad range of themes including governance, centralised recruitment panels, training pathways, selection processes, employment screening and the eRecruit system.

Phase Two of the review commenced in June 2015 and was completed in late 2015.

The purpose of Phase Two was solution generation through consultation with a broad range of key stakeholders to seek views of the key risks, issues and recommendations identified in the Phase One report and in considering these views, to make further recommendations on a practical way forward. An overview of the review is provided in Figure 1.

To this end, the Phase One report was utilised as a consultation document and was distributed to key stakeholders requesting further input on views of identified issues and recommendations. Further information regarding review methodology is provided in the following section.

The terms of reference of Phase Two of the Review are provided at Appendix A.


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Figure 1 - Overview of phase one and phase two

• May 2015 – April 2016

• Phase One Report widely distributed as a consultation document

• Consultation with internal and external stakeholders to discuss

implementable solutions to improve recruitment practices

• Phase Two Report with suggested approach for implementation

of recommendations.

Phase One

Phase Two

DIAGNOSTIC

SOLUTION GENERATION

• October 2014 – May 2015

• Literature review, policy review, consultation with internal

stakeholders, comparative analysis of interstate and international

• JMO recruitment practices

• Phase One Report with recommendations


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Methodology

Phase Two of the review commenced in June 2015 and was completed in late 2015 with the report being finalised in early 2016.

Phase Two involved extensive consultation with key stakeholders to seek their views on the key findings and recommendations outlined in the Phase One report and to identify agreed ways forward, resources and roles and responsibilities of all those involved in the recruitment process, both within and outside NSW Health.

The Phase One report was utilised as a consultation document and was distributed widely to key stakeholders.

The approach to this review is summarised in Figure 2. The review gathered information and opinion using the following methods:

Distribution of Phase One report to a range of internal and external stakeholders.

Consultation with key stakeholders – the consultation process was conducted through semi–structured interviews, forums and focus groups. Forums were hosted by LHDs but any interested stakeholders were invited and so could attend.

A total of 11 forums were held in addition to face–to–face meetings with selected specialty Colleges. A list of forums with locations is provided in Appendix B.

Written submissions were received from a range of key external stakeholders. Organisations providing written submissions in response to the Phase One report are provided in Table 2.

Surveys of applicants and senior medical staff seeking their views on the recommendations arising from the Phase One report. On–line survey instruments were developed for both stakeholder groups and made available for a period of three weeks during July–August 2015. The response rates of the on–line surveys were as follows: applicants (214), and senior medical staff, convenors and panel members (201).

Analysis of information received through the written submissions, survey results and consultation process.

Preparation and submission of draft report with recommendations and implementation plan.

Analysis of feedback on draft report

Submission of final (Phase Two) report

Figure 2 Summary of phase two review methodology

NSW Junior Medical Officer

Recruitment Strategy Review

PHASE ONE REPORTDr Jo Burnand

NSW Junior Medical Officer

Recruitment Strategy Review

PHASE ONE REPORT

Dr Jo Burnand

Semi-structured interviews

+ focus groups

Written submissions +

electronic surveys

Draft report and suggested approach

Phase Two

report

Analysis of

data

+ Analysis of feedbackFeedbackDraft

Phase One report


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Review governance

The project sponsor was the Deputy Director, Workforce Strategy and Culture, Workforce Planning and Development Branch of the Ministry of Health.

A Project Reference Group was established to provide direction and support to the consultant during the course of phase two of the review. The Membership of the Project Reference Group is provided at Appendix C.

Medical Specialty Colleges and associated organisations

• Australian and New Zealand College of Anaesthetists (ANZCA)

• Australian Orthopaedic Association (AOA)

• Australasian College for Emergency Medicine (ACEM)

• College of Intensive Care Medicine (CICM)

• Colorectal Surgical Society of Australia and New Zealand (CSSANZ)

• General Surgeons Australia (GSA)

• Medical Oncology Group of Australia Incorporated (MOGA)

• The Royal Australasian College of Medical Administrators (RACMA)

• The Royal Australasian College of Physicians (RACP)

• The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)

• The Royal Australian and New Zealand College of Psychiatrists (RANZCP)

• The Royal Australian and New Zealand College of Radiologists (RANZCR)

• Royal Australian College of Surgeons (RACS)

• The Royal College of Pathologists of Australasia (RCPA)

Other

• Ministry of Health (MoH)

• AMA ASMOF Alliance

Table 2: Organisations providing written submissions in response to the Phase One report


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The Phase Two report should be viewed as an adjunct to the Phase One report and read in conjunction with it. For the majority of recommendations, a diagram providing the key information pertaining to Phase Two outcomes ‘at a glance’ is provided. This includes the level of support, the priority and suggested timeframe. A more detailed explanation of “Phase Two at a glance’ is provided in Figure 3.

This report should be read in conjunction with the Phase One report.

Table 3 Phase One Recommendations by theme

Theme Phase One Recommendations

Governance 1, 2, 5, 6, 7, 10, 11

Training pathways 28, 29, 30, 31

Selection processes 15, 17, 18, 19, 20, 21, 23

Centralised recruitment panels 3, 4

Annual recruitment cycle 24

Employment screening 26, 27

Training in recruitment and selection 8

eRecruit system 9, 12, 13, 14, 16, 22, 25

The Phase Two report

should be viewed as an adjunct to the Phase One

report and read in conjunction

with it.

Preliminary comments

The Phase One report was very positively received, with many of those consulted both within and outside NSW Health, indicating a willingness to collaborate on further improvements to the statewide JMO recruitment strategy.

Many stakeholders, particularly external stakeholders, made comments to the effect that the report provided documentation and a rationale of complex recruitment processes. This has provided an opportunity to develop a shared understanding of the statewide JMO recruitment campaign and establishes a foundation for work with key stakeholders going forward.

The majority of stakeholders confirmed that the Phase One report identified the key issues of JMO recruitment with the exception of canvassing and management of pre–interviews. This is dealt with in a later section of this report.

The purpose of the Phase Two report is to provide an analysis of the outcomes of the Phase Two consultation. To assist with the consultation process, the Phase One recommendations were allocated to one of eight themes. The following report is structured according to these themes, which are summarised in Table 3.

Consistent with the positive response to the Phase One report, the majority of stakeholders, both internal and external, indicated their support for the majority of recommendations. Instances where specific stakeholders indicated disagreement with a particular recommendation or provided a caveat with support are detailed in the body of this report.

The Phase One report provided an

opportunity to develop a shared understanding of the statewide JMO recruitment campaign and establishes

a foundation for work with key stakeholders

going forward.


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Figure 3 – Phase Two At A GlanceExplanatory note: Throughout the Phase Two report, a diagram is provided against each recommendation summarising the outcomes of the

Phase Two consultation. This figure provides further information about the elements of the summary diagram.

Timeframes for recommendations were determined on the basis of the priority and in some cases, with consideration of the sequencing of implementation of recommendations.

Level of Support

Priority

MEDIUM

Timeframe

12 months

The level of support for a particular recommendation following consultation with internal and external stakeholders, including information views obtained through face–to–face meetings, focus groups, electronic surveys and written submissions.

A priority for each recommendation was assigned during Phase Two, determined on the basis of the risk analysis undertaken during Phase One.

High

SECTION TWO

Themes


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SECTION TWO | Themes | Governance

Recommendation 1

The NSW JMO recruitment strategy, characterised by a centrally coordinated bulk recruitment campaign should continue to be supported as providing the most efficient and cost effective approach to JMO recruitment within NSW.

Key findings from Phase Two consultation

There was a very high level of support by the majority of key stakeholders for this recommendation, consistent with the key findings of the Phase One consultation.

Many of those consulted expressed the view that given the unique characteristics of the JMO recruitment campaign there is a requirement to have the capability to support a JMO specific recruitment stream, which has functionality over and above general recruitment stream and is tailored to the needs of the bulk annual recruitment campaign.

In their written submission, ASMOF/AMA alliance articulated their support of this recommendation and noted that ideally the application process would be more centralised with applicants being required to write one application for similar roles.

Analysis

There was a clear message from those consulted to continue with the current strategy.

The improvements to the system were noted and appreciated by many key (particularly internal stakeholders.

There appears to be increasing engagement with key external stakeholders, particularly Colleges, in addressing common challenges.

Suggested approach

Refer to approach under Recommendation 2.

Level of Support

Priority

HIGH

Timeframe

< 12 months

High

“Clear benefits are likely to be delivered

through the strategies aimed at further automating,

streamlining and standardising recruitment processes. Consideration

of recruitment from an applicant, employer and medical college

perspective is especially important in ensuring transparency and

reduction of duplication.”

Submission from the Royal Australasian College of

Physicians


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SECTION TWO | Governance

Level of Support

Priority

HIGH

Timeframe

< 12 months

Recommendation 2

The roles and responsibilities of those involved in the annual JMO recruitment campaign need further clarification and restatement, with all stakeholders agreeing and accepting their roles and responsibilities.


There was a high level of support for this recommendation from the majority of stakeholders, with widespread recognition of the challenges of increasing numbers and pressure on the system in the context of confusion about roles and responsibilities as well as in some cases, duplication of effort.

Many internal stakeholders, (LHDs, senior clinicians, JMO Managers, Health Education and Training Institute and the MoH) acknowledged that although there have been significant improvements to the campaign in response to challenges, the increasing number of graduates combined with increasingly complex training programs have placed, and continue to place, the arrangements under significant pressure.

There was significant concern expressed about the current approach, with acknowledgement that the governance model currently used, which relies heavily on the good will of all participants, is simply not sustainable.

There was wide acknowledgement of the difference between policy and operational requirements in managing these risks but also widespread comments regarding the lack of clarity in governance arrangements in particular the lack of a final arbiter or decision maker. This limits the capacity for strategic response to emerging issues.

There was also concern expressed from a number of key stakeholders, (LHDs, senior clinicians, JMO Managers), regarding the historical arrangements leading to inequitable arrangements. Further, in the current system, there is no clear mechanism for redistributing or reallocating resources.

High



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Analysis

It is clear that given the above factors, that a new governance model for the oversight and management of the statewide JMO recruitment campaign is required to ensure its sustainability and manage risks in the future.

Suggested approach

The recommended approach would be the creation of a central unit to provide the

following functions:

• Determine roles and responsibilities of all internal stakeholders

• Provide oversight of the recruitment strategy

• Ensure appropriate resourcing, across the state, including the allocation of resources to statewide functions

• Provision of advice

• Act as the overarching decision maker

• Lead work with external stakeholders

The central unit will need to be given authority through a strong governance structure, including clear support by senior stakeholders in the Ministry and LHDs if the unit is to realise the strategic benefits.


A new governance model

for the oversight and management of the

statewide JMO recruitment campaign is required to ensure its sustainability

and manage risks in the future.


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Recommendation 5

Further work is undertaken with relevant Colleges to improve the timing of notification and transfer of information with respect to College recommended appointments.


There were high levels of support from LHDs and other internal key stakeholders for this recommendation, with multiple comments regarding issues that arise with respect to late notification and transfer of information regarding College recommended appointments, consistent with the Phase One consultation.

Some internal stakeholders questioned the appropriateness of College recommended appointments process highlighting that the practice runs counter to normal public health system recruitment practices and makes it difficult to properly establish an unambiguous employee/employer relationship.

In providing support to this recommendation, some stakeholders suggested that there should be a move to a joint selection process, noting that whilst there are differences between selection to College training programs and recruitment to public health system employment, there is also significant common ground.

Level of Support

Priority

MEDIUM

Timeframe

12 months

Responses from some medical training providers indicated a lack of appreciation of the downstream impacts of late notification and transfer of information on the employment process.

Analysis

Whilst LHDs clearly support this recommendation, responses by some medical training providers indicate a lack of awareness that this is an issue for the employer.

Suggested approach

The implementation of this recommendation requires further work at the level of individual societies and subspecialty Boards, including real time identification and a proactive response to issues as they arise. This could be a potential role for the central recruitment unit.

There is also a potential to extend this recommendation, in time, to joint selection and recruitment processes for identified positions, as suggested by a number of key stakeholders.

High



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Recommendation 6

Staffing of JMO Management Units is reviewed to ensure that they are adequately resourced to undertake designated roles and responsibilities associated with the bulk JMO recruitment campaign.


There were very high levels of support for this recommendation, particularly from LHDs, with multiple comments confirming the recognition of the burden on JMO Management Units.

Many comments were made during the Phase Two consultation highlighting the lack of visibility of actual work undertaken and the inherent risks to the system, identified during the Phase One review, including loss of staff, corporate knowledge and expertise.

A number of stakeholders also raised the lack of consistency of approach and resource allocation provided to JMO Management Units, a finding echoing issues identified during Phase One. The lack of surge capacity during the recruitment campaign was also raised.

Analysis

The adequate resourcing of JMO Management Units across the state remains a critical risk to the sustainability of the statewide JMO recruitment campaign.

Level of Support

Priority

HIGH

Timeframe

< 12 months

There was almost unanimous support by internal stakeholders for this recommendation, in recognition of this risk.

Suggested approach

A change to the governance arrangements as discussed under Recommendation 2, with the establishment of a central unit, may go some way to addressing this recommendation.

The central unit could lead a review of the staffing and resource requirements associated with the bulk JMO recruitment campaign to ensure consistency of roles, responsibilities and approaches.

Further, the central unit could consider models for the equitable allocation of responsibilities to those JMO Management Units tasked with performing statewide functions.

High


The adequate resourcing of

JMO Management Units across the state

remains a critical risk to the sustainability of the statewide JMO

recruitment campaign.


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Recommendation 7

Consideration be given to the development of career pathways and professional opportunities for JMO Managers that strategically supports the sustainability of this critical cohort of the NSW Health Workforce.


Consistent with views expressed in relation to the previous recommendation, the majority of internal stakeholders supported this recommendation.

Many of those consulted made comments about the variation in roles and responsibilities of JMO Managers across the state.

Some stakeholders suggested that an initial approach to this recommendation would be conducting a job analysis and role specification of JMO Managers with the aim of achieving greater consistency in approach.

It was acknowledged however, that this would best be undertaken following an analysis of the roles and responsibilities of all stakeholders in the JMO recruitment campaign as per Recommendation 2.

Level of Support

Priority

MEDIUM

Timeframe

12–18 months

Many JMO Managers who contributed to the Phase Two consultation highlighted limited capacity for acting up as well as limited opportunities to access education provided through HETI. Whilst the first issue is outside the scope of this review, there is clearly unmet need with respect to education for JMO Managers.

Analysis

There was a high level of agreement with respect to this recommendation, acknowledging that some aspects are outside the scope of the current review.

Suggested approach

In the first instance, the implementation of this recommendation requires a job analysis and specifications of the JMO Manager role to be completed.

This should be undertaken following the mapping and agreement of roles and responsibilities involved in the JMO recruitment campaign more broadly, (Recommendation 2), and should also take into consideration, other functions assigned to JMO Management Units which were outside the scope of this review.

This analysis would inform the development of further professional development activities and may assist HETI in strengthening the educational support provided to JMO Managers.

High



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Recommendation 10

Communication is improved regarding approval of the FTE to be advertised. This includes LHDs notifying the central panel host unit of the FTE to be advertised.


There were high levels of support for this recommendation with many (particularly internal) stakeholders confirming the issues articulated under this recommendation in the Phase One report.

The role of the Ministry of Health in facilitating communication between LHDs is limited and despite specific dates being detailed in Business Process Module 2, compliance under the current governance arrangements remains an issue.

LHD staff confirmed issues with regard to the notification of FTE, particularly for the central panels despite these published requirements.

Analysis

The current governance structures limit the capacity of the system to implement and enforce this recommendation across and between LHDs.

There is a potential role for the central unit in mapping and oversight of FTE, particularly for the central panels, supported by the business process modules.

Level of Support

Priority

MEDIUM

Timeframe

12–18 months

Suggested approach

The role of the central unit could be extended to include mapping and oversight of FTE, particularly for the central panels. This could become a central repository of information and data that would be updated on an annual basis, just prior to the commencement of the bulk recruitment campaign.

The successful implementation of this approach would require agreement and approval of all LHDs.

Over time, the central unit would have a role in monitoring compliance with the requirements articulated in the business process module.

High



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Recommendation 11

The Ministry of Health continue discussions with the Commonwealth Department of Health regarding the timing of STP funding.


There was mixed support for this recommendation, largely because of an acknowledgment of the Ministry of Health’s capacity to influence the timing of decision making in relation to STP funded positions.

It was also noted that the Federal Government is currently undertaking a review of the STP and there exists a degree of uncertainty regarding its future.

Internal stakeholders also highlighted that compared to issues identified under Recommendation 10, STP funded positions create less of an impact on recruitment processes.

Analysis

The MoH indicated that they have previously raised this issue with the Federal Government and that this remains a work in progress, pending the future of the STP.

Suggested approach

No further action required.

Level of Support

Priority

LOW

Timeframe

N/A

Some


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Recommendation 28

Length of training contracts should be pursued for as many training programs as possible.


This recommendation had high levels of support from both internal and external stakeholders, with many commenting that the successful implementation of this recommendation was not only a primary strategy in reducing workload, but would also be welcomed by junior doctors in providing more certainty regarding their employment.

The issues identified in the Phase One report as being barriers to length of training contracts were confirmed during the Phase Two consultation process, with some commenting that employment contracts provisions for the removal (from employment) of trainees unable to pass College training requirements needed further strengthening.

A number of stakeholders raised the issue of a lack of consistency in the application of length of training contracts, sometimes within specific specialties and even within hospitals. There appears to be a lack of transparency with respect to this and some argued that there needed to be greater visibility across the system of those programs adopting length of training contracts.

Level of Support

Priority

HIGH

Timeframe

< 12 months

Analysis

There appears to be increasing acceptance and adoption of length of training contracts across the NSW system and this is to be encouraged.

There is a potential role for the central unit in managing the allocation process of identified training programs, including setting targets for length of training contracts, to ensure consistency of application across the system.

Suggested approach

An audit of the application of length of training programs is required in the first instance, which the central unit could undertake.

The audit would inform the identification of training programs by specialty and LHD, including inconsistencies and gaps in current uptake and provide a platform for further work.

High

SECTION TWO | Themes | Training Pathways



Recommendation 29

Work is undertaken with LHDs and Colleges to identify the number of available training positions (pathways) including the prerequisite clinical experience and entry points for both run–through and uncoupled training programs.


Like the previous recommendation, there were high levels of support for this recommendation with many acknowledging the risk associated with the continued reliance on good will and informal arrangements in the context of increased numbers of medical graduates.

A number of those consulted highlighted the issue of nonalignment between the numbers of junior doctors required to provide clinical services and the current capacity to train, particularly in some specialties. This issue also extends to finite medical workforce requirements in those specialties in the long term.

This is a challenge for a number of specialties, particularly in light of the extension of clinical service delivery across the 24 hour period, but particularly relevant in the specialties of internal medicine, intensive care, and emergency medicine.

A number of Colleges, including RACP, RACS and CICM, indicated that they are undertaking work on strengthening prerequisite requirements within

Level of Support

Priority

MEDIUM

Timeframe

12–18 months

their training programs and there may be opportunities to collaborate with some Colleges to secure better alignment between specialty training and future workforce requirements.

For example, RACS has recently published a competency framework (JDocs Framework) to describe the tasks, skills and behaviours expected of the junior doctor at defined levels during PGY1–3. This provides advice to junior doctors wishing to pursue surgical training on the type of clinical experience they should undertake during the early postgraduate years.

Analysis

Whilst there is strong support for this recommendation and indications from a number of Colleges for the potential for collaboration, the implementation of this recommendation has a level of complexity that should not be underestimated.

Suggested approach

Progressive work on this recommendation in transitioning to a new system over time is required. A central unit would support this.

In the first instance, the central unit could map training pathways and available training positions in a small number of targeted training programs across the state.

High


25


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Some

Recommendation 30

Work is undertaken with LHDs and Colleges to explore the most effective mechanisms of tracking trainees as they progress through the training (employment) pipeline on a length of training contract.


There were mixed views on this recommendation, with a number of external stakeholders (Colleges) indicating that they already track progress of their trainees.

Whilst in its written submission, the AMA/ASMOF Alliance supported the recommendation, they noted that tracking of trainees is difficult due to the mobile nature of the system, particularly in relation to interstate and trans–Tasman rotations.

Those Colleges with a discrepancy between service requirements and training capacity (for example, RACP and CICM) indicated support for this recommendation, perhaps reflecting increasing concern regarding training pipelines and access to pre–and requisite clinical experience in the future.

Analysis

Whilst viewed as important by some stakeholders, this recommendation is of a lower priority compared with other recommendations arising from Phase One.

Level of Support

Priority

LOW

Timeframe

24 months

Suggested approach

The implementation of Recommendation 29 will inform the future requirement and viability of this recommendation.

Over time, there may be capacity for the central unit to collect information regarding trainees on length of training contracts.



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SECTION THREE | Training Pathways

Recommendation 31

Work is undertaken in collaboration with Colleges to strengthen performance management frameworks for effectively managing underperforming trainees within the employment context.


This recommendation had high levels of support from the majority of internal and external stakeholders.

It was noted that a number of Colleges had undertaken work on strengthening their trainee in difficulty pathways over recent years, but there was a need for improved alignment with the employer, particularly with respect to communication and transfer of information between Colleges and employers on trainees experiencing difficulties progressing in training.

This is particularly relevant where a trainee is identified as unlikely to progress in training. The timing of the notification to the employer is critical with respect to issuing contracts.

In their submission, ASMOF/AMA supported the recommendation, stating, “Particular care must be taken to establish genuine performance management frameworks in the context of the short term (12 month) contracts routinely used for medical trainees. Any developed framework would need to address any “buck passing” aspect that develops as a result of the 12 month contract situation.”

Level of Support

Priority

MEDIUM

Timeframe

12–18 months

Analysis

Whilst many Colleges have strengthened performance management frameworks, there remains a need to improve the communication between Colleges and employers with regard to underperforming trainees, particularly where a College identifies that a trainee is not progressing and will be removed from a College training program.

Suggested approach

Colleges are at varying stages of strengthening performance management frameworks as well as policies and processes to effectively manage underperforming trainees and this work is continuing.

Work could be undertaken progressively with individual Colleges to improve alignment of performance management frameworks between the College and employer, in addition to seeking agreements on the transfer of information.

High



28

Recommendation 15

For highly subscribed positions, consideration be given to removing words to the effect of “eligible to register with the Medical Board of Australia” (or equivalent) and having an unambiguous statement to the effect that applicants must hold current registration with the Medical Board of Australia in addition to currency of medical practice within the Australian healthcare system.


The majority of those consulted supported this recommendation. There were some divergent views, principally around the concern that overseas applicants not be disadvantaged, particularly Australian trained doctors with overseas experience.

Some stakeholders argued for the merits of continuing to consider overseas trained doctors, including in highly competitive programs whereby doctors can undertake some postgraduate training in Australia. These stakeholders also pointed out the benefits of Australian doctors having opportunities to undertake part of their training overseas.

In its submission, the MoH agreed with the recommendation and proposed that the default selection criteria require applicants to hold current registration but that the capacity to enable the more open criteria of “eligible to register” be made available for those positions where it was appropriate from a workforce perspective to consider overseas applicants.

Level of Support

Priority

MEDIUM

Timeframe

12–18 months

Analysis

On balance there is strong support for this recommendation, provided that the option to enable the broader criteria is configured in the system. Further work on selection criteria will address this.

Suggested approach

At the time of writing, this recommendation is being reviewed internally by the Ministry, with a view to implementation for the 2017 clinical year if approved.

High

SECTION TWO | Themes | Selection Processes


29

SECTION FOUR | Selection Processes

Recommendation 17

The wording of selection criteria used in position descriptions is reviewed to support a more efficient culling process by selection panels. This assumes a more sophisticated description of the role (following a job analysis) that incorporates not just the required clinical competence skill set, but also the non–technical attributes critical to the role.


There were high levels of support for this recommendation, with many of those consulted making comments about the risk of using global and sometimes quite loosely written selection criteria. That said, many made comments regarding the large body of work that would be required to implement this recommendation in a meaningful way.

The challenge of moving toward a more standardised selection criteria (discussed in more detail in the following recommendation) was also raised, given the (sometimes subtle) differences of roles and responsibilities of trainees, even within the same specialty and at the same level of seniority, across health services, depending on factors such as clinical service configuration, role delineation, medical workforce mix and geographical location.

Some stakeholders argued that core selection criteria for positions by specialty and seniority

Level of Support

Priority

HIGH

Timeframe

12–24 months

could be developed, with capacity to add on specific selection criteria that takes into consideration the requirements of the specific job at a particular facility.

Analysis

There appears to be agreement amongst many stakeholders, particularly within LHDs that there is merit in progressing this recommendation, whilst at the same time acknowledging the complexity involved in developing more standardised selection criteria that also addresses the differences between roles and responsibilities for like positions across health services.

Work on this recommendation will also provide opportunities to improve alignment of position descriptions with employer expectations.

Suggested approach

Progressive implementation of this recommendation is advised. This work could be potentially undertaken as a project, utilising external expertise and coordinated by a central unit, working in collaboration with LHDs.

High



30

Recommendation 18

Work with individual Colleges is undertaken to establish standardised specialty specific selection criteria (this assumes a job specification analysis) at various levels of training, including streamed PGY3-5 positions.


There was significant interest in and support for this recommendation, with some Colleges and Specialty Boards/Associations indicating a willingness to contribute to this work.

Some Colleges have undertaken work on selection criteria for selection into specialty training programs. Whilst acknowledging the difference between recruitment to employment and selection for training, it is clear that a collaborative effort is desirable.

The written submission from RACS supported this recommendation and noted that the JDocs framework, published in 2015, may provide guidance and support job streaming for PGY3–5 positions.

Other Colleges indicated that their NSW Regional Committees (however named) may be able to provide assistance.

Level of Support

Priority

HIGH

Timeframe

12–24 months

Analysis

A number of Colleges have recently undertaken or commenced work on selection criteria to specialty training programs.

The Colleges/Specialty Boards/Associations that specifically indicated support of this recommendation in their written submission and a willingness to progress work include the following:

• RACP

• RACS

• RANZCR

• RANZCP

• CICM

• AoA

Suggested approach

Refer to comments under the previous recommendation (Recommendation 17). Given the complexity of different training programs and positions, progressive implementation is recommended. This would provide opportunities for alignment with work on selection criteria (for training programs) undertaken by Colleges in addition to recognising employer specific requirements.

High



31


Recommendation 19

For regional and rural positions, consideration is given to allowing selection criteria to reflect an applicant’s interest in, commitment to, and suitability for rural medical practice.


Whilst there were high levels of support for the principle underpinning this recommendation across the range of stakeholders, there was also concern expressed about the specifics of the selection criteria to be used.

Analysis

There are some risks with implementation of this recommendation. Further work in the first instance is required to assess potential selection criteria that might be used and how these would be objectively assessed.

Level of Support

Priority

HIGH

Timeframe

12–18 months

Suggested approach

Other examples* that use selection criteria to assess an applicant’s commitment to and suitability for rural practice could be identified and reviewed for appropriateness within the JMO recruitment context.

High


*For example rural medical schools and rural medical

scholarship programs.

“There must be selection

criteria addressing commitment to rural/

remote practice.”

Senior medical practitioner


32

Level of Support

Priority

MEDIUM

Timeframe

12–24 months

High

Recommendation 20

Strategies are explored with the aim of reducing the total number of interviews being conducted. This will include a range of strategies such as: improving culling and short–listing techniques; increasing positions utilising preference matching; and increasing the number of centralised recruitment panels.


Many stakeholders consulted during Phase Two supported strategies aimed at reducing the workload and there was widespread recognition of the human resource implications (in senior clinician time) as well as the administrative burden associated with large numbers of interviews being conducted.

This was balanced with the recognition that any strategy aimed at reducing the number of interviews must still be supported by the NSW Health Recruitment and Selection Policy and built upon strong foundations of appropriate selection criteria and position descriptions.

Whilst a number of external stakeholders expressed support for this recommendation the importance of local (at a hospital or department level) input into recruitment processes, was also emphasised.

Further, it was noted by several stakeholders, that the implementation of some of the other recommendations of the Phase One review would address this recommendation.

Analysis

A reduction in the workload associated with the bulk recruitment campaign will occur with the implementation of many of the other recommendations made in the Phase One report.

There is clear interest from some Colleges to transition to joint selection and recruitment practices and further work to progress this is required.

Suggested approach

A potential role of the central recruitment unit could be to work with LHDs and Colleges to identify those positions appropriate for preference matching, centralised panels, or joint selection and recruitment practices.


“There should be more preference

matching, including across specialty fields.”

Junior medical officer


33


Recommendation 21

Work with postgraduate medical training providers, including Colleges, is undertaken to explore other methods of assessing applicants in the recruitment process.


A number of Colleges providing written submissions specifically indicated their support of this recommendation, with some providing information about the work that they have undertaken on improving selection of candidates.

This appears to be a common issue and there are shared challenges in the face of increasing numbers of applicants as the system moves from relative junior doctor shortage to one of workforce surplus.

Refer to findings under previous recommendation (Recommendation 20) for further comments.

Level of Support

Priority

MEDIUM

Timeframe

12–24 months

Analysis

Given the shared challenge of appropriate selection of either candidates (for postgraduate medical training programs) or recruitment of employees (for junior doctors), there is likely to be some benefit of sharing information on best practice selection techniques and contributing to a shared body of knowledge.

Suggested approach

Refer to previous recommendation (Recommendation 20).

High


“The process as it currently stands is

oversimplified and places too much emphasis on performance at a single

interview.”

Senior medical practitioner


34

Recommendation 23

Work is undertaken with relevant Colleges to align referee requirements with NSW Health policy and allow for the sharing of referee reports. This is likely to improve the quality of the referee report, in addition to reducing the administrative load on senior clinicians during the recruitment period.


There was a high level of support for the principles underpinning this recommendation, with widespread acknowledgement of concerns regarding current practices of referee checks being undertaken during the JMO recruitment campaign.

There was significant concern expressed during both Phase One and Phase Two of the review by a large number of stakeholders that the current referee checks lacked validity and were largely tokenistic. At the same time, many stakeholders highlighted the importance and value of appropriate referee checks.

In the Ministry submission the following statement was made:

“The MoH expects the referee report to fully comply with NSW Health policy and should assess the suitability of the trainee as an employee, addressing their employment performance, completed by someone who can attest to that performance.”

Level of Support

Priority

HIGH

Timeframe

12–18 months

Whilst the different perspectives of employer and College were acknowledged, some Colleges also expressed a willingness to share College assessments with employers. Improvements and increasing clarity regarding required performance for progression through College training programs are also likely to impact on this recommendation.

Analysis

There appears to be a willingness to progress this recommendation with better sharing of information on trainee assessments by Colleges likely to have a positive impact.

Suggested approach

The implementation of this recommendation could be approached in the first instance by undertaking a mapping exercise to identify gaps between College and NSW Health referee requirements. This would include alignment of information and clarification of requirements for each stage of training within a particular specialty. This work will also be supported by work undertaken on selection criteria.

High


Recommendation 3

Centralised recruitment panels should be supported and expanded to other specialties.


There was a high level of support expressed by internal and external stakeholders for this recommendation. Applicants were generally very supportive of the expansion of centralised recruitment panels.

It was evident from a number of submissions, in addition to face–to–face meetings, that terminology used in recruitment processes, particularly with respect to centralised recruitment processes is not uniformly applied.

A number of stakeholders highlighted the benefits of centralised recruitment panels and statewide processes, particularly for applicants. Whilst a number of Colleges specifically highlighted support for this recommendation, not all Colleges agreed and there was some concern expressed for a ‘one size fits all’ approach.

Level of Support

Priority

HIGH

Timeframe

< 12 months

Analysis

There are significant benefits to be gained through the implementation of this recommendation and a central unit would support this. However, there are also significant resource implications (see Recommendation 4).

It is noted that there are a number of different models and approaches used in centralised recruitment processes. This has led to variable interpretation of terminology used in centralised recruitment processes. There is a requirement to improve the consistency of language and terminology used in the JMO recruitment campaign.

Suggested approach

Refer to next recommendation (Recommendation 4).

High

SECTION TWO | Themes | Centralised Recruitment Panels

35

“Centralised panels as far as

everyone being at the same place at the same

time with candidates only having to be interviewed once, is a major bonus.”

JMO Manager



36


Recommendation 4

The arrangements for centralised recruitment panels, including allocation of appropriate human and fiscal resources to ensure their effective and sustainable operation, needs to be agreed between LHDs.


Refer to key findings under Recommendation 3.

Analysis

As identified under Recommendation 3, there are key benefits and efficiencies to be gained by establishing centralised recruitment panels for targeted training programs.

However, It is clear that not all JMO Units are currently equally resourced, appropriately placed or have the adequate capability to take on additional responsibilities involved in the management of centralised panels.

There is evidence that the larger JMO Units are already at capacity and it is unrealistic to expect smaller JMO Management Units to take on statewide functions.

Level of Support

Priority

HIGH

Timeframe

< 12 months

Suggested approach

There is a role for the central unit to provide oversight of centralised recruitment panels (and processes).

Many Colleges indicated support and interest in working with NSW Health on this recommendation. Agreement needs to be reached on (i) which positions, (ii) content of the position description, including selection criteria, and (iii) how interviews will be conducted. In the first instance, a process needs to be developed and agreed that allows for new programs to establish centralised recruitment panels.

A new governance model, through a central unit, could provide oversight of the allocation of resources in addition to supporting the establishment and expansion of centralised recruitment panels to additional training programs.

An agreed glossary of terms used within the statewide JMO recruitment campaign needs to be developed and communicated to all stakeholders. A suggested glossary is provided at Appendix D.

High


37


Recommendation 24

Further work is undertaken with jurisdictions and Colleges to improve alignment of recruitment dates with key training milestones within and across training programs. This implies a hierarchical approach to the advertising and recruitment of positions.


Although there was a high level of support expressed during the Phase Two consultation for this recommendation, many stakeholders acknowledged the level of complexity in aligning dates across specialty training programs and jurisdictions, particularly in the context of the cascading impact of recruitment decisions.

Analysis

Given the level of complexity in dealing with multiple jurisdictions, initial efforts may be better concentrated on NSW specific recruitment dates, in consultation with Colleges.

A number of Colleges indicated in their written submissions, a willingness to work with NSW Health on improving alignment of key training milestones with recruitment dates.

There is a requirement for clearer communication between all relevant stakeholders with respect to key training milestones and the relationship to recruitment dates.

Level of Support

Priority

HIGH

Timeframe

12 months

Suggested approach

There is a potential role for the central unit in developing and publishing an annual recruitment plan, including an agreed hierarchy of recruitment dates. This would be informed by further consultation and collaboration with relevant Colleges.

In addition to recruitment dates, the annual recruitment plan (however named) would document key training milestones of participating Colleges for the information of all those involved in the statewide JMO recruitment campaign.

High

SECTION TWO | Themes | Annual Recruitment Cycle

SECTION TWO | Themes | Employment Screening

Recommendation 26

Consideration is given to strategies that will reduce the repeated 100–point checks being undertaken on junior doctors during the same recruitment campaign.


In acknowledgment of the significant administrative burden during the recruitment campaign, there was a high level of support from internal stakeholders, as well as applicants, for this recommendation.

In their submission in response to the Phase One recommendations, the MoH proposed that the administrative burden be addressed whereby the National Criminal Record Check (NCRC) consent form and 100 points of identification are managed at one point only during the recruitment process, in much the same way as the referee checks are processed by a single job owner on behalf of the system.

Analysis

The adoption of the above strategy suggested by the MoH may provide a practical approach to the implementation of this recommendation.

Level of Support

Priority

MEDIUM

Timeframe

12–18 months

Suggested approach

Module 4 of the Recruitment and Selection policy is reviewed to include provision for the NCRC consent form and 100–point checks to be managed at one point only during the recruitment process in much the same way as referee checks are currently processed. This would also have eRecruit system ramifications.

High

38



39

SECTION TWO | Themes | Employment Screening

Recommendation 27

Consideration is given to requiring applicants to upload a signed CRC consent form at the time of submitting the application and subsequently providing the original form for validation when they present for interview.


Whilst there was some support for this recommendation, the majority of internal stakeholders noted that there have been (and continue to be) multiple changes to the eRecruit system that may supersede the requirement for this recommendation.

Analysis

This recommendation requires further consideration in lieu of changes to the eRecruit system with the potential to implement the above suggestion if required.

Suggested approach

No further action required at this stage.

Level of Support

Priority

LOW

Timeframe

N/A

Low


40

SECTION TWO | Themes | Training In Recruitment Selection

Recommendation 8

Consideration is given to working with Colleges on the development of a medically focused recruitment and selection training package, aligned with public sector employment requirements.


Whilst the majority of those consulted agreed with the issues identified in the Phase One report with respect to lack of compliance by senior medical staff in training on recruitment and selection, there were mixed views in response to this recommendation.

Although medical training providers submitting written responses provided generic support, the lack of specific responses to this suggested a limited appetite for this recommendation.

Internal stakeholders highlighted the multiple training programs currently available and it was suggested that prior to developing new programs, the first step might be to encourage greater completion rates of existing resources.

A number of Colleges have recently developed training packages in selection of trainees (for example, RACS and RACP).

The MoH submission suggested that any training package should be aligned with NSW Health employment (rather than more generic public sector) requirements.

Level of Support

Priority

LOW

Timeframe

12–24 months

Analysis

This recommendation had some (mixed) support by key stakeholders and is considered a low priority.

The majority of stakeholders support senior medical staff attending training on recruitment and selection as an important risk mitigation strategy in the recruitment campaign.

There may be some value, in the longer term, of reviewing College selection training programs to identify possible areas of alignment with NSW Health employment requirements.

Suggested approach

As an interim strategy, a medically focused recruitment ‘fact sheet’ with key recruitment and selection principles could be developed for Heads of Departments, convenors and panel members.

Some

SECTION TWO | Themes | eRecruit System

Comments

Although a detailed examination of the eRecruit system was outside the scope of this review, given its critical importance to providing the platform for the effective functioning and implementation of the statewide JMO recruitment strategy, several recommendations with respect to the eRecruit system were included in the Phase One report.

There was very strong support by key stakeholders for the JMO eRecruit system that has been developed and improved over time to meet the unique characteristics of the statewide JMO recruitment campaign. Stakeholders were concerned to ensure that there continued to be a recruitment system with specific functionality to support the annual recruitment campaign.

The Phase One Recommendations pertaining to changes to the system have been provided to the Ministry of Health for consideration in future developments with eRecruit systems to support the statewide JMO recruitment strategy. Whilst the specifications of the eRecruit system are primarily out of scope for this review, a summary of recommendations arising from Phase One is included in Table 4.

41



42

SECTION TWO | Themes | eRecruit System

Table 4 – eRecruit system Recommendations

No Recommendation Level of Support PriorityCapacity to implement in enhanced platform

9 Further work is undertaken to migrate the bulk JMO recruitment campaign to a paperless IT system.

High Medium Yes

12 Further work is undertaken on the web–based eRecruit system to enable applicants to more easily locate positions.

High Medium Yes

13 The concept of placing a limit on the number of applications per applicant is explored with key stakeholders.

Some Medium N/A

14 The current character limit on selection criteria is reviewed. Low Low N/A

16 The eRecruit system is configured to enable automatic processing of applicants who do not meet the selection criteria as described in above recommendation, without the requirement for a manual review of the application.

High Medium Yes

22 Consideration is given to the creation of a third category list whereby in addition to the eligibility list for successful applicants, potentially eligible but lower ranked applicants could be placed ‘on hold’.

High Medium Yes

25 The JMO eRecruit system is configured so that an applicant can only accept one position. In the event that an applicant, having already accepted a position, receives an offer for a more preferred position, the eRecruit system should require the applicant to decline the first position, prior to the applicant being able to accept the second.

Some Medium Yes


43

SECTION NINE | eRecruit System

Additional issues identified during Phase Two

The Phase Two consultation process confirmed that the initial phase of the review (Phase One) had accurately identified all the issues and there appeared to be high levels of agreement regarding priority of issues.

The exception to this was the issue of canvassing or pre-interviews. Whilst there had been multiple reports during the Phase One consultation process of the pre-selection interview and job interview undertaken by potential applicants, concerns about this appeared much more prominent during the Phase Two consultation process.

It is difficult to determine whether this reflects a growth in the practice across more sites or an increase in identifying it as a concern, particularly in the context of increasingly competitive recruitment processes and higher numbers of applicants.

Whilst there is evidence of canvassing in one form or another across many specialties, it appears to be more common in physician training, particularly in the large tertiary centers.

One approach taken by a unit faced with a surge in requests for pre-interview visits, (given the resource implications and potential issues in terms of appropriate recruitment practices) was to cease individual pre-interview meetings but to host an information sessions to which all interested applicants are invited to attend.

There is currently minimal advice to the system on how to manage requests from individual trainees who wish to visit a department or meet senior medical staff ahead of or during the recruitment process.

In other recruitment contexts, potential applicants seeking further information through direct telephone or in person contact with the nominated contact person or line manager about a position or organisation to which they are intending to apply, is generally regarded positively and seen as a reflection of an applicant’s interest in the position.

In the context of junior medical officer recruitment, given the volume of positions and numbers of applicants, if each applicant sought to visit the site or meet with the senior medical staff member responsible for a position, the impact on the system would be very significant.

It is clear that guidelines need to be developed to assist LHDs and sites in managing requests from potential applicants to visit the unit/department and meet with relevant senior medical staff as part of the recruitment process.

SECTION TWO | Themes | Final Comments

SECTION THREE

Appendices


45

SECTION THREE | Appendices

A. Terms of Reference/Scope

The Phase One report will be utilised as the consultation paper, with recommendations and key risks/issues servicing as the discussion points and subject areas to be elaborated upon.

The key groups of stakeholders in this review are:

• Ministry of Health

- Workforce Planning and Development (Project Sponsor/Manager)

- Workplace Relations

- Deputy Secretary, Governance, Workforce and Corporate

• Local Health Districts, Specialty Health Networks

- Chief Executives

- JMO Units

- HR Units

- Medical Workforce Units

- Directors of Medical Services

- Directors of Prevocational Education and Training, Directors of Training

- Workforce Executives

- Recruitment Convenors (including Clinical Heads of Departments)

• HealthShare NSW

• Health Education and Training Institute (HETI)

• Agency for Clinical Innovation

• JMOs/Applicants

• Medical Specialty Colleges and Associations

• Australian Salaried Medical Officers Federation (ASMOF)

• Health Services Union (HSU)



46


B. List of meetings by location

Local Health District

Illawarra Shoalhaven LHD

Illawarra Shoalhaven LHD

Southern NSW LHD

South Eastern Sydney LHD

South Eastern Sydney LHD

Sydney LHD

Northern Sydney LHD

Western Sydney LHD

Western Sydney LHD

Sydney LHD

South Western Sydney LHD

South Western Sydney LHD

N/A

N/A

N/A

Sydney LHD

N/A

Hunter New England LHD

N/A

Location

Wollongong Hospital

Wollongong Hospital

Queanbeyan Hospital

St George Hospital

St George Hospital

Royal Prince Alfred Hospital

Hornsby Kuringai Hospital

Westmead Hospital

Westmead Hospital


Liverpool Hospital

Liverpool Hospital

Melbourne

Melbourne

HETI office, Gladesville


MoH, North Sydney

John Hunter Hospital

Sydney

NB – Forums and meetings hosted by LHDs were open to all interested NSW Health stakeholders who were invited to select a location and time most convenient to them (by category), regardless of which LHD they worked for.

Forum/Meeting

JMO Management Unit/Administration

Medical Administration/Clinical Departments

JMO Management Unit/Medical Administration/HR

JMO Management Unit

Medical Administration/Clinical Departments

JMO Management Units/Medical Administration

Clinical Departments/Medical Administration

JMO Management Units/HR/ Medical Workforce

Directors of Medical Services/Clinical Heads of Departments

Clinical Heads of Departments/Recruitment Convenors

JMO Management Units/Administration

Clinical Heads of Departments

College of Intensive Care Medicine

Royal Australasian College of Surgeons

NSW Health Education and Training Institute (HETI)

JMOs/Applicants

ASMOF/AMA

Clinical Heads of Departments/JMO Management Units/HR

The Royal Australasian College of Physicians


47


C. Membership of the Statewide JMO Recruitment Strategy Project Reference Group

Ms Deborah Frew (Chair)

Deputy Director, Workforce Strategy and Culture, Ministry of Health

Dr Kathleen Atkinson

Executive Director of Medical Services, Western NSW LHD

Ms Janice Baker

Principal Advisor, Workplace Relations, Ministry of Health

Mr Gareth Boylan

Manager, Recruitment Strategy, Workforce Strategy and Culture, Ministry of Health

Ms Merielee Desepida

Senior Policy Officer, Recruitment Strategy, Workforce Strategy and Culture, Ministry of Health

Dr Alison Latta

District Director of Medical Workforce, Northern Sydney LHD

Dr Anthony Llewellyn

Medical Director, Health Education and Training Institute

Dr Linda MacPherson

Medical Advisor, Workforce Planning and Development, Ministry of Health

Ms Jean Mah–Collins

Manager, Medical Allocations and Development Unit, Concord Hospital, Sydney LHD

Ms Kyra Maher

JMO Manager, Southern NSW LHD

Ms Kylie Midson

Manager, Statewide eRecruitment Operations, HealthShare NSW

Ms Michelle O’Heffernan

Principle Policy Advisor, Workplace Relations, Ministry of Health

Ms Jodie Spencer

Manager, Medical Administration, Orange Health Service, Western NSW LHD

Dr Dale Thomas

Director of Clinical Services, Shoalhaven District, Illawarra Shoalhaven LHD



48


D. Glossary of terms

Annual (bulk) recruitment campaign A specific period of time during which the majority of JMO positions are advertised and recruited to. Most applicants who are recruited to a JMO position in the NSW public health system apply via its JMO recruitment campaign.

Centralised recruitment A broader term (compared with centralised recruitment panel) that refers to processes whereby a number of like JMO positions (within a specialty or stream) are recruited to through the same mechanism, either at a state level, across a number of LHDs or through a training network. Unlike the centralised recruitment panel, centralised recruitment can include multiple advertisements and multiple interview panels, though generally the latter will be held in a single location.

Statewide centralised recruitment A business process within the NSW Health JMO annual recruitment campaign whereby the panel recruits for a particular specialty across the state using one advertisement within the JMO eRecruit system, and which involves a centralised interview process.

Clinical year The clinical year describes the 12-month period which has a common commencement date for junior doctors and prescribed term dates. The clinical year commences in early February of each year.

Junior medical officer Junior doctors from Intern (PGY1) through to Postgraduate Fellow. Appointment of interns, with the exception of rural preferential recruitment, occurs by a separate process and was not considered in this review.


49


Length of training contract An employment contract offered to medical officer employees undertaking a vocational training program. It covers the minimum potential period for completion of the employee/trainee’s training program, but may vary depending on the training program, including whether the training program is divided into basic and advanced training components, and any previous training the medical officer may have undertaken. In most circumstances, the length of training contract will not be less than 2 years.

Recruitment campaign See entry under annual (bulk) recruitment campaign.

Run through training program This term is used to describe the structure of vocational training programs that include the basic and advanced components within a single curriculum. Once selected into a run-through specialty training program, a trainee will be able to complete specialty training in the broad specialty group or specialty, subject to progress. Examples of run through training programs include anaesthetics, obstetrics and gynaecology and emergency medicine.

Uncoupled training program This term is used to describe the structure of vocational training programs where the basic and advanced components of the training program are separated, usually by a barrier exam. Trainees are required to complete the basic component and then apply, through a competitive merit based process for the advanced component of the training program. An example of an uncoupled training program is physician training.


50

Acknowledgments

I would like to gratefully acknowledge the many people who participated in this review. To those individuals who participated in forums and face–to–face meetings during the Phase Two consultation, I would like to thank you for your insights and contributions offered to the review process.

I would also like to thank all of the external stakeholders, particularly Colleges, the AMA/ASMOF Alliance and other organisations who provided written submissions to the review, including in some cases, those who provided opportunities for face–to–face meetings.

To the members to the Statewide JMO Recruitment Strategy Project Reference Group who provided oversight of the review process, thank you for your support and advice.

Finally, I would once again like to acknowledge both Gareth Boylan and Merielee Desepida for their unwavering support and assistance provided to me for the duration of the review process.

JB

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